When I went to the pharmacy to get my birth control, I had a co-pay. I thought all contraceptive coverage had to be free?

In general, health plans must cover all 18 methods of contraceptive coverage that the FDA has currently approved for women with reproductive capacity without cost sharing if a provider determines the product to be medically appropriate for the patient, unless the health plan is grandfathered. The list of approved contraceptive methods is available here. While health plans must cover all methods approved for women, they are not obligated to cover each form of contraception under each method. For example, if a health plan covers both a generic and brand name birth control pill, it can impose cost sharing on the brand name over the generic as part of its medical management. However, if your doctor determines you should take the name brand birth control because it’s medically appropriate, the health plan must cover the brand name birth control without cost sharing.

Note that federal rules allow eligible organizations including employers and insurers that have an objection based on “sincerely held religious beliefs or moral convictions” to exclude some or all contraceptives from a health plan, and a previous process in place to ensure enrollees still had access to contraceptive coverage is no longer required. The U.S. Supreme Court recently allowed these rules to go into effect, but they are subject to further legal proceedings, and additional rulemaking efforts are underway. Also, some fully insured employer plans are also subject to state laws that require contraceptive coverage. To determine if your current policy covers contraceptives, and what methods are covered, check with your plan administrator. You should be able to request plan materials that list covered and excluded services, including contraceptives.